Editor's note: This piece was written by Dr. Margaret Paul, a therapist with more than 40 years of experience. It's not a diagnostic tool but is hopefully a resource. Please consult a trusted health care provider before making any decisions about your treatment plan.

I recently spoke at "The Real Truth About Health" conference in Orlando, Florida. In one of the talks, I spoke on a panel with Dr. Irving Kirsch, author of the best-selling book, The Emperor's New Drugs.

According to research that Dr. Kirsch explores in this book, a lot of what we know about depression is wrong. Not only did Big Pharma invent the idea of a brain imbalance that causes depression and is fixed with a drug, but antidepressants only have a placebo effect. Also, says Dr. Kirsch, the relapse rate for people on meds is much higher than for people who undergo psychotherapy.

It's a fascinating book and one that resonated with me because, in my decades as a relationship counselor, I've seen people heal from depression naturally, without drugs.

If it's not a brain imbalance that causes depression, then what is it?

In my many years of experience in working with depressed individuals, and according to literature (see Gut and Psychology Syndrome by Dr. Natasha Campbell-McBride and Brain Maker by Dr. David Perlmutter), there are three major causes of depression.

1. Painful life situations

When life is very painful, of course we will be depressed. Situational depression is normal. Life events can cause great heartbreak, grief and feelings of helplessness. These feelings need to be felt with much compassion, and then released out of the body, rather than being numbed with meds.

Rather than suppressing extremely painful feelings, you need to learn to lovingly manage and release the feelings from life situations such as the following:

Loss of a loved one

Loss of a job

Natural disasters such as earthquakes, tornadoes, floods, or fire

Marital and parental challenges

Child abuse

Violent situations such as rape, beatings, or theft

War

You need to grieve and compassionately embrace your feelings of heartbreak, grief, and helplessness rather than suppress your feelings with drugs. Suppressing the feelings can cause them to get stuck in your body, and I believe that stuck feelings can cause illness.

A gut imbalance and the resulting gut permeability could be caused by sugar, wheat, gluten, and processed chemical-laden foods, or by a lack of macro- and micronutrients from clean organic foods. Other factors include stress, lack of exercise, lack of sleep, and lack of sunshine.

3. Self-abandonment

Medication covers over the feelings that let you know you are abandoning yourself — emotionally, physically, financially, organizationally, spiritually, or relationally.

There are many ways you might have learned to abandon yourself, such as:

Ignoring your feelings, rather than being present in your body

Judging and shaming yourself

Turning to various addictions as a way of numbing yourself out and avoiding responsibility for learning from and lovingly managing your feelings

Making others responsible for your feelings of worth and safety

Eating badly

Lack of exercise

Lack of sleep

Procrastination

Overspending

Under-spending (even when money is available)

Being consistently late, disorganized, cluttered

Lack of a spiritual practice

Giving yourself up to others

Not speaking up for yourself

Using anger, blame, judgment, and/or violence to try to control others

This is certainly not a complete list. Anything we do that results in feeling depressed — as well as feeling anxious or shamed — may be a form of self-abandonment.

Healing Depression

I've worked with thousands of people who have healed their clinical depression by learning to love themselves rather than continuing to abandon themselves. People heal their depression when they:

Get the psychotherapy and trauma therapy they need.

Learn to take loving responsibility for their feelings.

Learn to connect with a spiritual source of love and comfort to help them manage the pain of life.